New Diagnosis vs. Misdiagnosis: VA Rating Impact

New Diagnosis vs. Misdiagnosis: VA Rating Impact

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Posts: 43

Nov 10 08 11:22 AM

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Hi,

Here is the situation. I was placed on TDRL by the military last year with a diagnosis of Chronic Fatigue Syndrome. I was rated at 60% by the VA, and was
also rated at 10% x2 for each elbow and 10% x2 for each knee due to joint damage as evidenced by x-ray. My total rating is 90%. My situation is somewhat
complicated because I am currently unable to work (as explained below) and would like to try to get a 100% rating, or at least an IU designation.

I have recently seen a civilian rheumatologist, who has diagnosed me with a form of inflammatory spondyloarthritis, and will soon begin treatment with Humira.

While in the military, I did see a rheumatologist, and was noted to have enthesitis and iritis (symptoms of spondlyarthritis), so I could argue a service
connection for the spondylarthritis, especially since the military rheumy noted that my symptoms could be an early form of this condition.

Now to the questions:

1. Am I better off leaving my VA rating alone or should I try to obtain a rating for the arthritis? It would seem that in rating the arthritis, a rater I
might consider that the CFS was a misdiagnosis and therefore wipeout the separate CFS rating and perhaps the elbow/knee joint ratings. The rater then might
rate the arthritis and joint damage as one rating. Thus, success in getting the arthritis rated might result in a lower overall rating. Nobody has officially
"undiagnosed" me with CFS, but as CFS is a diagnosis of exclusion, I am not sure one can logically have both conditions.

2. I have a 0% rating for sinusitis. Due to a recently botched sinus surgery, I have double vision that may be permanent. I am considering trying to
establish service connection for this secondary condition of double vision. Does applying for a rating of this condition jeopardize other ratings I have been
awarded? For example, if it's not in my best interest to try to establish a claim for Number 1 above (because of potential lower rating) does filing for
the double vision open up Number 1 such that it could be downgraded?

As mentioned initially, I am now unable to work. The double vision is part of the problem. I would like to get a rating that reflects that. But as the
saying goes...be careful what you ask for...

Anyway, any advice will be appreciated. Especially interested to hear what cruiser thinks about this.

Howdy. I would love to answer your questions but some of what you need answers to need to be answered by an expert like Cruiser or Navy, etc on the CFS. But,
with things being what they are, diagnoses are a lot easy to make every day.

As for filing for other conditions, only you can make that decision but can do so with some educated advice such as you are seeking.

You used the word jeopardize, and it is a word that is somewhat true but that is not how the VA really works. The VA doesnt use the opening of new claims to
"go after" other ratings, IMHO, but when you have an open claim, then all claims are also opened to be looked at again. This is typically done to
ensure that the veteran is not being screwed over. However, there are times that there were mistakes made and found when a claim was opened. Once found though
the VA has no choice but to fix a problem.

In the end though, we all take a chance when we open new claims or continue to keep claims open thru appeals. It is my strong opinion though that the VA doesnt
look to lower any veterans ratings unless they absolutely must do so by the force of law. You see, there are other veterans that are doing your claim decision.

My point - if your disabilities have not gotten better then I would not expect the VA to lower their ratings. Based on the evidence, the VA will usually raise
the rating or keep it what it was. This though is my opinion and you are the one that must be comfortable with an open decision.

Were I in your shoes, I'd simply apply for IU based on the fact you cannot work due to your service connected disabilities. More than likely C&P exams
will be ordered to review your disabilities and if any increase in them is warranted, it will be increased. At the same time the rater will take all the input
from the exams and determine if you deserve IU.

1. Am I better off leaving my VA rating alone or should I try to obtain a rating for the arthritis? It would seem that in rating the arthritis, a rater I
might consider that the CFS was a misdiagnosis and therefore wipeout the separate CFS rating and perhaps the elbow/knee joint ratings. The rater then might
rate the arthritis and joint damage as one rating. Thus, success in getting the arthritis rated might result in a lower overall rating. Nobody has officially
"undiagnosed" me with CFS, but as CFS is a diagnosis of exclusion, I am not sure one can logically have both conditions.

Whether or not there was a misdiagnosis is not a call that a Rating Specialist would make. It is not uncommon for a diagnosis to change over time
with the initial diagnosis being refined to reflect a different condition as the condition develops. In your case the question for the doc is exactly how many
separate conditions do you have, 1, 2, or 3?

Based on what you have reported, I suspect that the spondyloarthritis is the condition for which you are already being compensated, at least as far as the
elbows and knees are concerned, and perhaps even the CFS, but that would be for a doctor to say. This is much too complicated for me to try to explain in this
setting, especially without seeing your records. I would ask your doctor about how this current diagnosis fits in with the prior diagnoses of CFS and whatever
the diagnoses are for your elbows and knees. I am assuming some type of arthritis but you didn't say. If those conditions were actually
spondyloarthritis, then it would be to your advantage to have the diagnosis for your service connected condition reflect this.

Again, there is simply too much going on here for me too say much more. These are medical issues.

I have a 0% rating for sinusitis. Due to a recently botched sinus surgery, I have double vision that may be permanent. I am considering trying to establish
service connection for this secondary condition of double vision. Does applying for a rating of this condition jeopardize other ratings I have been awarded?
For example, if it's not in my best interest to try to establish a claim for Number 1 above (because of potential lower rating) does filing for the
double vision open up Number 1 such that it could be downgraded?

If your doctor says that your double vision (diplopia) is the result of surgery for your service connected sinusitis, then you should definitely
request secondary service connection. The maximum evaluation for diplopia is 30 percent.